Dry Needling Therapy- What is it and is it for you?

What Is Dry Needling?

Katie Breeze writes:

Dry needling is largely used to relieve pain and the symptoms associated with a variety of soft tissue dysfunction.

During a dry needling session, single use, sterile stainless steel needles are inserted subcutaneously into tendons, ligaments, fascia, scar tissue, & peripheral nerves. This is done to change structures and functions within the body (Dunning et al, 2016). Most commonly, the needles are inserted into hard, discrete knots in muscle known as myofascial trigger points (MTrP). These MTrPs are associated with pain syndromes such as Myofascial Pain Syndrome (MPS). This is a condition that can be both chronic and acute. It involves dysfunction in muscles and the surrounding connective tissue (Shah, Thaker, Heimur, Aredo & Sikday, 2016). MPS is seen worldwide and is reported to affect 10% of all adults accounting for acute and chronic pain complaints.

What happens?

The needles are inserted intramuscularly to release tight areas. These affect nociceptive pain, improve blood flow and stimulate the release of essential bio chemicals (neurotransmitters) to help relieve pain and promote the healing process.

Needles maybe left in situ for 5-7 mins or lightly rotated and/or advanced in and out in a piston-like action. This is done in to the required soft tissue to elicit a local twitch response (LTR). The twitch response provides a strong neural impulse which breaks the MTrP circuit and relieves pain.

Evidence to date supports that dry needling improves pain control, reduces muscle tension and normalises dysfunctions of the motor end plates. These are the sites at which nerve impulses are transmitted to muscles. This can help speed up your return to active rehabilitation.

 

 

I use Trigger Point Dry Needling to successfully treat a variety of musculoskeletal injuries and painful conditions such as;

  • achilles tendonitis,

  • tennis elbow,

  • postural hypertrophy of the shoulders (muscle tension),

  • tension headaches,

  • common running injuries such as Posterior Tibial Tendonopathy and Shin Splints,

  • overuse injuries such as RSI of the forearm, and

  • Rotator Cuff tendonopathy or strain.

It is a technique used by many manual therapists. This includes Osteopaths, Physiotherapists, Chiropractors, Occupational Therapists, and Podiatrists, as well as Sports Therapists and Massage Therapists.

There is a significant benefit of using Dry Needling when combined with other soft-tissue techniques. Subsequent to dry needling therapy being applied, other manual therapy techniques like mobilisation and manipulation become much easier to apply. They often require much less force to achieve a restoration in joint mobility.

DRY NEEDLING THERAPY – FAQ’s 

Below are some commonly asked question and misconceptions regarding Dry Needling Therapy. If after reading you are still unsure whether Dry Needling Therapy is appropriate for you, please get in touch via the chat link below. We will be happy to answer any questions you have.

How is dry needling different from acupuncture?

Dry needling is not Acupuncture. Acupuncture treats for the purpose of altering the flow of Qi (or energy) along traditional Chinese meridians. Dry needling follows evidence-based guidelines, recommended “point” locations, and dosages for the treatment of specific conditions. The goals are to address neuromuscular conditions, relieve pain, and/or improve range of motion.

Dry needling has an anatomy-specific focus. The needles will be inserted directly into the tight muscle rather than up and down the path of its energy.

Does dry needling hurt?

Dry needling uses very thin needles that are typically not painful. Because the needles do not contain medication, we are able to use very thin needles. They are 8x smaller than those used for your vaccines with your medical doctor.  While some areas may be more tender than others, dry needling typically does not cause more pain than your current symptoms.

However, certain areas of the body, such as the calf, occasionally elicit some soreness post needling. This is mainly to do with the muscle readjusting to the trigger, or the local twitch response (that is a desired response) when the needles were first inserted. Typically the soreness last up to two days. The cramping sensation during session is also a favourable response.

While some of you will experience relief and improvement after the first session. Others will take a few more sessions to see the full benefit of dry needling. Aside from the soreness, there is no other adverse effects of dry needling when correctly performed.

Does dry needling make you tired?

Drowsiness, tiredness, or dizziness often occurs after treatment in less than 3% of patients. If this affects you, you are advised not to drive until you feel you are at your baseline.

How effective is dry needling?

Dry needling from a clinical perspective has proven to be an extremely useful tool. Most notably in patients who have long-term or chronic muscle tightness that does not resolve with independent stretching or strengthening programs. Dry needling research supports its effectiveness in regards to relieving pain, muscle spasms, and muscle tightness by decreasing trigger points in the muscle.

How long do dry needling benefits last?

Length of relief will vary from person to person. With initial treatments, results typically last several days. With each additional treatment, we are able to increase the window of relief meaning longer relief with each additional attempt.

How long does dry needling take to work?

Although you may have some soreness after a dry needling session, you will often notice some improvement in your symptoms within 24-48 hours. Again, the intensity of this improvement will ideally increase with each additional session. As you adjust to the treatment, post-treatment soreness will tend to decrease.

How many dry needling sessions do I need?

In acute pain situations, only one session may be needed. For more chronic pain conditions, it may take several treatments to notice a change. Because dry needling can have a cumulative effect if you do not notice results after the first session we typically recommend 2-3 treatments before deciding to pursue other options. We tend to start your dry needling plan at 1x/week. The goal is to increase the length between sessions as we go along. Your individualised treatment plan will be discussed with you during your initial consultation. Additionally, it will be revised accordingly as treatments progress.

How long is a dry needling session?

A stand alone dry needling treatment is typically a 30-minutes however it may be used alongside other treatment modalities within an hour long treatment.

What do you wear to a dry needling session?

Wearing loose-fitting clothes tends to be the best option when you are expecting to undergo dry needling. This will allow the therapist to access the muscles while allowing you to stay comfortable. Shorts are easiest when attempting to access the muscles of the leg, and loose-fitting or easy to move underwear can help your therapist access the muscles of the lower back, hips and glutes.

Are there any Potential Adverse Reactions to Dry Needling?

Some of the mild adverse reactions include needling pain, nausea, bleeding or bruising, drowsiness, increased symptoms, fainting, or very rarely local skin inflammation due to a bent or broken needle.

Other more serious but rare events include pneumothorax, cardiac tamponade, haemothorax, deep venous thrombosis, popliteal artery occlusion, brain stem injury, septic arthritis, and abscess.

My qualification is in Medical Acupuncture & Advanced Dry Needling Therapy. The full details of the training and accrediting bodies is shown in this web page

Are there any Absolute Contraindications to Dry Needling?

YES, there are some conditions and situations for which dry needling is absolutely contraindicated. These are listed below:

• Congenital or acquired heart valve disease

• Recent cardiac surgery or CCF

• Recent radiotherapy

• No consent

• Known spontaneous bleeding or bruising

• Pacemaker or intra-cardiac defibrillator (electro dry needling)

• Acute cardiac arrhythmias

• Open skin wounds or injuries

There are also some relative contraindications to Dry Needling. These include:

  • Varicose veins

  • Malignancy

  • Haematoma

  • Pregnancy

  • Eczema or psoriasis or mole

  • Peripheral neuropathy

  • Infections

  • Tendency to bleed—anti-coagulant therapy

  • Compromised immune system

  • Previous adverse reaction to acupuncture or dry needling

  • Seizure induced by previous medical procedure

  • Unstable diabetics

  • Unstable angina

  • Epilepsy (stable or unstable) or schizophrenia

  • Chronic oedema or lymphoedema

  • Manic depression

  • Fatigue

For more information on all the treatment modalities offered at C1 Chiropractic Health Centre or for details of how to make an appointment contact us on 0117 922 1542 or visit our website at http://c1healthcentre.co.uk/

 

About Katie Breeze

I've been passionate about health and fitness since I was a child, though my specific interests have definitely evolved as I've progressed through the many different stages of my own life. Understanding your individual needs and objectives, enables me to create an entirely bespoke holistic programme of therapeutic care and exercise prescription, to help you achieve your goals. I am a Level 4 Sports Therapist providing Sports & Remedial Therapy for individuals with a huge array of physical pain and limitation; from postural dysfunction of the desk bound worker, to the weekend warrior or those with soft tissue injuries whether they be sports related or otherwise. Treatment modalities I use vary between treatments according to what is appropriate for the client and soft tissue dysfunction at the time. A treatment may consist of a range of assessment and techniques including; Movement Analysis, Manual Myofascial Trigger Point Therapy, Dry Needling Therapy, Muscle Energy Techniques, NeuroMuscular Facilitation and Rehab and Corrective Exercise Prescription.

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